Medicare Care Manager RN Team Lead / Hybrid

Job ID: 259375    Posted 6/11/2024


Location: New York, New York


Job Type: Direct Hire


Category: Case Management


Position: 259375


Skills: Medicaid


Salary Low: $100000 - Salary High: $110000


Duration: 2 Weeks



Job Description

For more than 30 years, this health plan has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.  They provide the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens, and Staten Island through a comprehensive list of products.

Medicare Care Manager Team Lead – Manhattan, NY ( 2 days in the Manhattan office and 3 days remote )
Position Overview

  • Manages day to day activities of the case management team (Case Managers and Case Management Associates) to ensure quality outcomes (i.e., reduction in emergency room visits and hospital admissions, improved member satisfaction) and cost effectiveness.
  • Perform hands-on, participatory management where all aspects of day-to-day case management operations are supervised, and feedback is shared with the leadership team for the purpose of meeting program goals and the implementation of continuous quality improvement strategies.
  • Spends approximately 80% of the time providing training, supervision, ongoing support, and mentorship.
  • Facilitates the successful execution of the Integrated Case Management program by providing day to day supervision and applying problem solving skills to ensure the delivery of member- centered case management, improved access to community resources and improvement of overall health status of members.

Job Description

  • Provide clinical guidance and supervision to assigned Case Managers and Case Management Associates to promote efficient and effective delivery of case management services.
  • Supervise day to day activities  to make certain that case management services are provided in accordance with clinical guidelines, established processes, and organizational standards.
  • Conducts, mentors, and evaluates staff, problem solves and implements strategies to facilitate the overall goal of the program.
  • Supervise the entire case management workflow including case selection, interventions and goal setting, follow-up/follow-through activities, documentation, and escalations.
    Ensure case management activities are conducted in a safe, efficient, and effective manner to promote continuity and quality of care.
  • Review, develop and modify day-to-day workflows to ensure timely completion of visits and attainment of productivity benchmarks.
  • Perform ongoing quality review of cases to ensure accuracy and compliance.
  • Evaluate and document staff performance; coach staff to improve both quality and quantity of skills attaining optimal performance.

Minimum Qualifications

  • Bachelor’s Degree required; Masters preferred; and
  • A minimum of 5 years of Case Management experience in a health care and/or Managed Care setting required; or
  • An equivalent combination of training, educational background and experience in related fields and educational disciplines. 
  • Minimum of 2 years managerial/leadership experience in a Managed Care and/or health care setting required.
  • Ability to proficiently read and interpret medical records, claims data, pharmacy and lab reports, and prescriptions required
  • Ability to work closely with member and caregiver.
  • Ability to work in a facility-based environment collaborating with all levels of Health Care Providers, members, and families.
  • Registered Nurse, Licensed Clinical Social Worker, or Licensed Master Social Worker with a current New York State License.

Salary Range $105,000 to $110,000 with Excellent Benefits (Pension Plan)

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Why Us?

At RCM Health Care Services, we redefine healthcare staffing, creating an environment where your career thrives and flourishes. Our commitment to your success is woven into the fabric of our culture, offering diverse opportunities for both seasoned professionals seeking challenges and newcomers ready to make their mark. As a part of the RCM family, you'll experience more than just a job – you'll find a platform for continuous growth and fulfillment.

We have cultivated an ecosystem where healthcare professionals not only find rewarding career opportunities but also a community that values their skills and dedication. Your success is our priority, and our collaborative environment ensures you're never alone on your professional journey. Competitive salaries and comprehensive benefits reflect our dedication to your well-being, allowing you to focus on what matters most – delivering exceptional care. Join RCM Health Care Services, a trusted partner with a proven track record since 1975 and embark on a journey where your path to a fulfilling healthcare career truly begins.

About Us

With a legacy spanning over 45 years, RCM Health Care Services is a leader in connecting healthcare professionals with rewarding career opportunities. Our foundation is built on cultivating relationships with school districts, setting the stage for our expansion into placing providers across diverse facility types. As we evolved, our expertise diversified across various divisions including School Services, Behavioral Health/ABA, Travel, Nursing, Therapy, HIM, Permanent Placement, Foreign Recruitment, Locums Tenens, and much more.
Our mission is clear: to elevate healthcare standards by empowering talented healthcare professionals and forming strategic partnerships with top-tier healthcare institutions and schools across the country. We proudly hold the Joint Commission Gold Seal of Approval, showcasing our commitment to the highest standards in healthcare.
Our commitment goes beyond filling positions; we actively build careers, foster growth, and make a profound difference in the lives of both our candidates and the patients they serve.